Actually, it was a point about what the writers of the constitution considered arms in the meaning of the second amendment... they were muskets, not even revolvers much less semi-automatic weapons. I happen to be quite aware of the "actual problem", and I'd like to work with all people to solve it, since I know people who have been killed by fire arms... even if I am a pedant. What is your damage?

Interesting I would have thought it was much earlier. I had to look it up on wikipedia:

>The first device identified as a gun, a bamboo tube that used gunpowder to fire a spear, appeared in China around AD 1000. The Chinese had previously invented gunpowder in the 9th century.

&

>English Privy Wardrobe accounts list "ribaldis", a type of cannon, in the 1340s, and siege guns were used by the English at Calais in 1346.The earliest surviving[clarification needed] firearm in Europe has been found from Otepää, Estonia and it dates to at least 1396.

I think it's fair to say that guns have been around a lot longer than the USA has.

USA drug purchases fund most global drug research. That money comes from somewhere. It's fine for us to question whether this is the best way for drugs to be marketed in our nation, but for the rest of the world to do so seems a bit ungrateful?

Oh the noble Americans! Suffering under the yolk of oppressive pharma so the rest of the world can take advantage! Praise be.

Really, though, it's absurd to demand that the rest of world be grateful. Try changing the system in the US and you will find it exceedingly difficult due to the deep pockets of big pharma and the massive role money plays in the US democratic system. So no, the rest of the world should not be grateful that a capitalist system is doing what it does.

Haha there are probably some who would "demand" that but I'm not one. You seem to be agreeing with me, though? Our drug marketing regulations are after all just "a capitalist system... doing what it does". No point in complaining about it, especially since unlike most aspects of American hegemony it actually helps all you unfortunate non-Americans. b^)

That doesn't make sense to me. If life-saving drugs don't make money and pharmas are purely rational actors trying to maximize profit why would they bother investing money into them anyway? Also "life-saving" is a high bar, I was merely talking about "useful". If you figure out a great remedy for baldness you might not save lives but you wont have any issue making billions selling it, advertising or not.

If you only way to sell a drug is to convince people they need it in the first place then I think it ought to be illegal, yes. Look at the massive opioid crisis in the USA which stems in great part from pharma pushing drugs people didn't really need and getting them addicted. If that's the only way you can figure out to fund cancer research we have a big problem indeed.

Opioids don't need marketing. Opioid aficionados will seek them out at great expense and difficulty. In a sense, that's good, because the question of appropriate pain management is complicated enough even without considering marketing. Physicians who didn't know that opioids were addictive before prescribing them weren't victims of irresponsible marketing; they were poor physicians. That isn't to say that pain shouldn't be treated, rather it is to say that treating pain is difficult and we've done a poor job so far. Part of that is vilification of opioid users, part of it is abdicating all decisions to physicians. When I was 13yo I was capable of saying "no I don't need another shot of Demerol" while barely conscious in a hospital bed. Just the same, as long as I live, I will never forget the first two shots I did receive. They were that great. But that isn't pharma; we've used opioids for centuries.

When economic historians of the future consider the current era's pharma industry, they will marvel at how much money was spent for how little benefit. The cure to cancer will not come from pharma. (Quite possibly from biotech, but that's a different thing.) The incentives are wrong: cures are less valuable than indefinite treatments. Look how much they have to charge for the hep C cure. If that were a mere treatment, they could amortize their "research costs" over a lifetime. Even better than treatments that work are treatments that might work. One poor suffering patient might be prescribed 15 such, multiple times a day for the rest of her life.

Still, for many hep C sufferers even an expensive cure is a good thing. Many other conditions respond in agreeable ways to some medicines for some patients some of the time. Maybe the research costs too much for some of them. One suspects that a more rational FDA process could cut costs for most drugs, but no one who would benefit from that has any control over the process itself. The whole edifice is a bit monstrous. Just the same, if the golden goose requires drug marketing, do we really want to do away with drug marketing?

I work in pharma research in the US, so I'm pretty biased here, but I have thoughts. In my opinion, the more useful kinds of marketing is to physicians. Help them understand new products and where they fit in the treatment paradigm for whatever indications your company makes.

On the other hand, there are tons of people who have stories about knowing something was wrong, being told by 3 physicians that it was nothing, then finding a 4th who diagnosed them with something the others missed because a patient is usually their own strongest advocate.

A boss of mine a few years ago mentioned that he thought the best solution was for a disease to have ads. All of the companies that have drugs in market for that disease will want to buy in and say "Feeling X symptoms? Talk to your doctor; you might have Y". Of course there are still a ton of problems (there was no market for impotence until Pfizer re-branded it as ED, there are lots of diseases where there are low single digit options, etc), but it's a good start, in my opinion.

To tie this back to the topic at hand, there really isn't a trusted authority in the role of crypto purchases, aside from maybe a very forward-thinking/risky financial manager? Part of the problem is the very benefit: marketing to unqualified people gives access for anyone to grow their wealth, but also gives anyone the ability to lose a ton of money. It's sort of the central problem with Libertarianism overall.

Your colleagues in marketing agree with you, though they probably have a different definition for "useful". This 2012 article[0] says pharma spent $24B in marketing to professionals vs $4B to consumers. I assume relatively more is spent on consumers now but didn't find any more recent numbers.

It is also worth mentioning that pharma now spends more on marketing than research.

> On the other hand, there are tons of people who have stories about knowing something was wrong, being told by 3 physicians that it was nothing, then finding a 4th who diagnosed them with something the others missed because a patient is usually their own strongest advocate.

Are there any peer reviewed studies to back this up? As a researcher in the field I'm sure this is the threshold you would want to meet before making such an assertion.

Also, are there any studies that can tell us the ratio of marketing spent on informing consumers of legit ailments vs what is spent on kickbacks, hiring former cheerleaders as marketers, junkets for doctors, coupons for the on patent drug when the off patent drug works just fine, paying the generic company to not sell its drug to compete, etc or any of the other shady practices that pharma engages in?

That's essentially untrue in developed nations. Everyone has gotten a prescription at some point.

Unless you mean to say that drug companies can advertise to prescription drug users for the specific window when they happen to be actively taking a prescription drug. Which seems rather difficult to manage and would require a massive privacy violation to achieve. Plus I'm not clear what the delivery mechanism would be unless you're just talking about inserts delivered with the drugs themselves.

What that means is that the particular Rx drug being advertised can only be advertised to consumers of that Rx drug in question. So insulin can only be advertised to people with diabetes.

The interesting thing about this is that it leaves most of the power with the HCP.

As for the delivery mechanism, there weren't too many options in the recent past, however, these days there are POC marketing companies like Outcome Health (and others) and a growing number of software applications are aware of their user's health condition / needs (with permission of course either explicitly or by virtue of the intended use, like apps for diabetes patients, etc.).